NHS rated on open and honest reporting culture in world leading transparency drive

New
safety drive with ambition to save up to 6,000 lives and halve avoidable
harm

New
data published yesterday will for the first time allow the public the
opportunity to compare key safety measures across hundreds of NHS Trusts in
England.

It
shows that the vast majority of NHS hospitals are rated as “good”
or “ok” for their reporting culture. However, around one in five
acute trusts, or 20 per cent have been rated as “poor” for open and
honest reporting, underlining the need to support NHS staff to report and raise
safety concerns.

The
data has been published as the Health Secretary outlined a package of measures
to ensure the NHS remains one of the safest healthcare systems in the
world:

NHS
Choices safety website: a new
microsite which gives patients, regulators and staff unprecedented
safety data. The seven safety indicators will allow people to look at safety
and staffing data across the country, driving up competition and
standards.

Launch of the Sign up to Safety
campaign: Sir David Dalton, Chief Executive of Salford Royal NHS Foundation
Trust will lead a major patient safety campaign which aims to halve avoidable
harm, and in doing so save up to 6,000 lives over the next three years.
Following the Mid Staffordshire Inquiry, the Government introduced major
reforms to the NHS. Yesterday’s measures will build on these and help
create an open culture that will improve patient safety and give staff the
confidence to know that they will be supported and listened
to.

Last week, the Commonwealth Fund released a study that
ranked the UK 1st in the world for quality of care, including safety. However
healthcare systems around the world continue to have high levels of avoidable
harm. Tackling unsafe care and avoidable harm such as medication errors, blood
clots and bed sores will not only improve patient outcomes but will save the
NHS money that can be reinvested into patient care. A 2007 study estimated the
cost of adverse events due to medication errors at £774 million per year
and the NHS currently spends around £1.3 billion per year on litigation
claims.

Health Secretary, Jeremy Hunt said:

Globally, the levels of avoidable harm in health care
are shocking. The NHS is already leading the way on safety, more than 300
people suffered as a result of some of the most serious types of preventable
harm last year. Today’s campaign will go further and aims to save
thousands of lives.

We
have come a long way since Mid Staffordshire, however there are too many cases
where NHS staff who have raised concerns about safety have been ignored. Today
we have introduced measures to help tackle this head on.

Sign up to Safety campaign

All
Trusts are invited to join the Sign up to Safety campaign which aims to drive
up safety standards throughout the NHS, halve avoidable harm and save up to
6,000 lives over the next three years.

Twelve Trusts are already developing plans that will
outline how they will reduce avoidable harm and save lives. An essential part
of the plans are that Trusts must provide information on how they will plan to
tackle two national patient safety priorities and two local
priorities.

NHS
Trusts who sign up and develop plans will have their plans reviewed by the NHS
Litigation Authority and, when approved, they will receive a financial
incentive from the NHS Litigation Authority to support implementation of the
plan.

Sir
David Dalton, Chief Executive of Salford Royal Hospital and leader of the
campaign said:

I
am delighted that this campaign focuses on saving lives and reducing harm. This
is the right thing to do. Healthcare carries inherent risk and while healthcare
professionals work hard every day to reduce this risk, harm still happens. Some
is unavoidable but most isn’t. Sign up to Safety seeks to reduce this
harm and is a unique opportunity for us all to work together to listen, learn
and act to make a difference.

NHS
Choices safety website

Going further than any other health care system in the
world, the NHS Choices safety website has published an unprecedented amount of
patient safety information to allow patients, regulators and staff to see
safety performance across a range of indicators.

The
seven indicators are:

CQC
standards

Patient safety reporting: “open and honest”
reporting

Safe staffing - % of nursing and midwifery hours filled
as planned

Infection control and cleanliness

Patients assessed for risk of blood
clots

Responding to patient safety alerts

Recommended by staff to their relatives and
friends

Chief Nursing Officer for England, Jane Cummings,
said:

Today is a watershed moment – for the first time,
patients and the public will be able to find out about staffing levels down to
ward level in their local hospital.

It
isn’t possible to compare safety standards on staffing levels yet but the
new site puts services more closely under the microscope, highlighting
variations where questions need to be asked and most importantly, identifying
where action is needed to deliver improved care for our
patients.

Freedom to speak up: An Independent Review into creating
an open and honest reporting culture in the NHS

Sir
Robert Francis QC, the barrister who led the public inquiry into failings at
Mid Staffordshire NHS Foundation Trust, will chair a new independent review
into the reporting culture in the NHS and how staff on the frontline can be
supported to raise concerns.

The
independent review will look at what further action is necessary to protect NHS
workers who speak out in the public interest and help to create the kind of
open culture that is needed to ensure safe care for patients. It will issue a
call for evidence from NHS whistleblowers, NHS frontline staff, NHS employers,
trade unions, professional and systems regulators, amongst others and will use
this evidence to learn lessons from historic cases so the NHS can learn for the
future.

It
will provide independent advice and recommendations to the Secretary of State
for Health on measures to:

Build confidence to speak out: by ensuring that NHS
staff in England can raise concerns about any aspect of the quality of care,
malpractice or wrongdoing at work and be sure that they will be listened to and
that appropriate action will be taken

Prevent mistreatment: staff should not suffer
detrimental treatment as a result of raising concerns. The review will explore
whether there are appropriate remedies so that those mistreating can be held to
account;

Consider independent dispute resolution: the review will
consider whether new and/or independent mechanisms are needed to resolve
disputes in the NHS that involve whistleblowers; and consider options so that
where tribunals or courts find in favour of individuals who have raised
concerns, arrangements are in place to help them go back to work in the
NHS;

Separate out concerns about care, malpractice or
wrongdoing at work from personal grievance disputes: however complex cases
become, in future, concerns about care need to be pulled out and dealt with
separately; and

Seek out and learn from best practice. Sir Robert
Francis QC will chair a new review on whistleblowing and culture in the NHS.
The review will look at what further action is necessary to protect individuals
who speak out and to help to create the kind of open culture that enhances
safety.

Sir
Robert Francis said:

We
need a culture where ‘I need to report this’ is the thought,
foremost in the mind of any NHS worker that has concerns – a culture
where concerns are listened to and acted upon .

The
Mid Staffordshire Public Inquiry showed the appalling consequences for patients
when there is a “closed ranks” culture. This review will help us to
learn more about what we need to do to support staff to raise concerns, and
support the NHS to listen to them.

Organisations are being asked to develop a plan that
describes what they will do to reduce harm and save lives. They will be asked
to identify two or more national patient safety priorities and two or more
local priorities to focus on in their plans.

As part of this work, they will be engaging local
communities, patients and staff to ensure that the focus of their plan reflects
what is important to the community they serve. They will make public their plan
and update regularly on their progress against it.

The
support available to those who sign up:

Those organisations that sign up to the campaign can
draw on a variety of expert support to help ensure that they realise the
ambitions described in their plans. These include the use of staff briefings
and de-briefings, the use of communication tools, increased skills in
investigations and communicating with patients, and the approaches to designing
safe care using tools and techniques from other industries, including
checklists.

Collaboratives – are regionally based safety
improvement networks that will work across whole local systems and all health
care sectors, to deliver locally designed safety improvement programmes drawing
on recognised evidence based methods. They will begin their work later in the
year.

Fellows – work is underway to create a group of
5,000 respected, enthusiastic and effective safety improvers who will become
the backbone of patient safety improvement. The group will launch later this
year and organisations who sign up to safety will benefit from the expertise of
the fellows and can also support their own staff to become
fellows

SAFE team – a new Safety Action for England team
will be developed to provide short-term support to individual trusts in the
area of patient safety. SAFE will provide trusts with a clinical and managerial
resource to help to develop organisational and staff capabilities to help
improve the delivery of safe treatment and care.

Look at those
organisations that have signed up already and you can follow progress
on twitter via @signuptosafety and using #signuptosafety